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1 CITY OF EASTON BUREAU OF CODES AND INSPECTIONS 2 nd Floor, 123 South Third Street, Easton, PA phone (610) fax (610) PERMIT APPLICATION Owner: Phone # Mailing Address: Contractor: Phone # Fax # Mailing Address: Insurance: W/C Self-insured Exemption PA Home Improvement Lic # DESCRIPTION OF BUILDING USE: Residential: One-Family Dwelling Non Res: Specific Use: Two-Family Dwelling Use Group: Multi-Family Dwelling No. of Units Change in Use: Yes- Former: Detached Semidetached Attached Mixed Use: No. of Res Units No. Comm Describe the proposed work: CARBON MONOXIDE ALARMS Carbon monoxide alarms shall be provided when applying for any permit where a fuelfired appliance exists or where there is an attached garage. They shall be installed outside each separate sleeping area. IMPROVEMENT COST office use only a. Building $ Fee $ Permit No. Fee $ b. Electrical $ Inspection fee $ Permit No. c. Plumbing $ Fee $ Permit No. d. Mechanical $ Fee $ Permit No. e. Other $ Fee $ Permit No. Total Total Issued The applicant certifies that all information on this application is correct and the work will be completed in accordance with the approved construction documents and PA Act 45 (Uniform Construction Code) and any additional approved building code requirements adopted by the Municipality. The property owner and applicant assume the responsibility of locating all property lines, setback lines, easements, rights-of-way, flood areas, etc. Issuance of a permit and approval of construction documents shall not be construed as authority to violate, cancel, or set aside any provisions of the codes or ordinances of the Municipality or any other governing body. The applicant certifies he/she understands all the applicable codes, ordinances and regulations. I certify that the code administrator or the code administrator s authorized representative shall have the authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of the code(s) applicable to such permit. Signature of Owner or Authorized Agent REVIEWED: APPROVED DENIED *see reverse for REQUIRED INSPECTIONS

2 REQUIRED INSPECTIONS: Construction work must be inspected in accordance with these instructions. This department will carry out such periodic inspections during the progress of work as are necessary to insure that work installed conforms to the approved plans and all applicable codes. The owner or other responsible person in charge of work must notify this department when work is ready for any required inspections specified below. If the work is not completed as scheduled, you must cancel the inspection prior to 9:00 a.m. on the day scheduled. Inspections will be performed within two (2) business days of the time for which they are scheduled. The work must not proceed in a manner that will preclude the inspection(s) until it has been made and approval given. To schedule an inspection please call forty-eight (48) hours prior to the requested inspection date and you must supply the following information: permit number type of inspection required property address and location of work contact person contact phone number Please note that PA UCC compliance approved plan(s), with any comments, must be on site at the time of the inspection. Failure to supply plan(s) will result in a $50.00 fee being assessed with payment being made prior to scheduling any further inspections. This fee will be assessed for each occurrence. Required inspections for all subcodes as indicated: 1. The bottom of footing trenches before placement of footings, except that in the case of pile foundations, inspections shall be made in accordance with the requirements of the building subcode 2. Foundations and all walls up to grade level prior to back filling 3. All structural framing and connections prior to covering up with finish or infill materials; plumbing underground services, rough plumbing, electrical rough wiring inspection; panels and service installation, insulation installation 4. Inspections as noted: a. Plumbing supply and drain lines and set fixtures Note: Plumbing tests are required for all water supply lines and drainage lines. Water supply lines require 60 lbs., drainage lines require 5 lbs. b. Underground plumbing prior to covering c. Electrical inspection (rough and final approved sticker required on panel box) d. Mechanical (rough and final - spec sheets must be on site) e. Drywall (prior to tape and spackle) and/or insulation f. Window installation/replacement (please leave labels on windows to verify U-factor) g Above ceiling h. Fire Alarm Inspection i. Elevator certificate j. Other: 5. Final inspection upon completion of work 6. Final Certificate of Occupancy. It is in violation and subject to fine to occupy before Certificate of Use and Occupancy has been issued by the construction official.

3 CITY OF EASTON - ph: fax: ELECTRICAL PERMIT Electrical Contractor: Phone # Address: Insurance: W/C Self-insured Exemption Other PA Home Improvement Lic # ITEM NO. LOCATION, SIZE, BRIEF DESCRIPTION Ceiling Outlets Switches Plug Receptacles Baseboard Heating Air Heaters Ranges Lighting Circuit Other Circ. Panel Size Range Cond. Emergency Lights/Exit Signs 110 V AC Interconnected Smoke Detectors* Other *Floor plan must be submitted with permit application. All work, materials and construction to be in accordance with the appropriate regulations as adopted by the City of Easton. Signature of Applicant ==================================================================== REVIEWED: APPROVED DENIED

4

5 CITY OF EASTON - ph: fax: PLUMBING PERMIT Master Plumber: Plmbg. Lic. No: Issuing City: Contractor: Phone Address: Insurance: W/C Self-insured Exemption Other PA Home Improvement Lic # List all Fixtures (proposed): New Installation Re-Installation NO. FIXTURE KITCH BATH OTHER PIPE SIZE AND BRIEF DESCRIPTION Water Closet/Bidet/Urinal Bathtub Lavatory/Sink Shower/Floor Drain Washing Mach/Dish Washer Commercial Dishwasher Water Heater Water Util. Connection Sewer Util. Connection Storm Drainage System Spec. & Indirect Waste Sys. Hose Bib/Water Cooler Garbage Disposal Indirect Connection Drainage Pipe Cleanout Sewer Ejector Traps Interceptors Backflow Devices Vents Special Health Care Plumb. Other All work, materials and construction to be in accordance with the appropriate regulations as adopted by the City of Easton. Signature of Master Plumber EXISTING: PROPOSED: Drainage Material Size Drainage Material Size Bldg. Sewer Material Size Bldg. Sewer Material Size Water Service Material Size Water Service Material Size Venting Material Size Venting Material Size REVIEWED: APPROVED DENIED Sewer Connection (per EDU) Approved Fee Address Assignment Approved Fee Sidewalk Approved Fee

6 CITY OF EASTON -ph: fax: MECHANICAL PERMIT Mechanical Contractor: Phone # Address: Insurance: W/C Self-insured Exemption Other PA Home Improvement Lic # TYPE OF EQUIPMENT NO. LOCATION, SIZE, BRIEF DESCRIPTION Air Pollution Systems Air Handling - Distribution Sys. Air. Cond. Units - Systems Boilers - Steam/Hot Water Chimney/Vent/Liner Clothes Dryer Conversion Burner**SEE REVERSE SIDE FOR ADDITIONAL INFO ** Floor Furnaces Forced Air System Fuel Oil Piping Gas Piping Systems Fire Suppression System Range Hoods - Commercial Range - COM DOM Refrig. Unit or System Solar Systems Sprinkler System Stand Pipe Unit Heaters Ventilation Systems Wall Heaters 1) If the approved work involves a heating conversion that will replace an oil-fired system with a different source of heat, you are to completely remove the oil filler pipe. 2) Emergency shut-off switch for gas furnace shall be located in the immediate vicinity of the furnace. Emergency shut-off switch for all other systems shall be located at the top of stairs. 3) Any asbestos to be removed must be done by a certified contractor. 4) Evaluate chimney as per IMC 2009, or IFGC ) Evaluate and provide combustion air as per IMC or IFGC * * * Copy of all installation requirements shall be on site at time of inspection. * * * Signature of Applicant ============================================================================== REVIEWED: APPROVED DENIED

7 **There are two (2) options available for the conversion of an existing oil burner to gas** 1. Appliances is listed and labeled for gas. 2. Provide an approved engineering evaluation of the fuel fired appliance with the gas burner conversion installed per section G and R of the 2009 IRC. This document is required to be prepared by a Pennsylvania Design professional.

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